@article{ref1,
title="The impact of ptsd treatment on the cortisol awakening response",
journal="Depression and anxiety",
year="2014",
author="Pacella, Maria L. and Feeny, Norah C. and Zoellner, Lori and Delahanty, Douglas L.",
volume="31",
number="10",
pages="862-869",
abstract="BACKGROUND: Posttraumatic stress disorder (PTSD) is associated with abnormal functioning of the hypothalamic-pituitary-adrenal (HPA) axis; however, limited research has examined whether cortisol levels change following successful PTSD treatment. The current study examined the impact of successful PTSD treatment on the cortisol awakening response (CAR). <br><br>METHOD: Twenty-nine adults participating in a treatment trial for chronic PTSD provided saliva samples (upon waking, and 30-, 45-, and 60 min postwaking) before and after receiving either prolonged exposure therapy or sertraline. PTSD responder status (i.e., loss or retention of a PTSD diagnosis) served as the predictor variable. Outcome measures included area under the curve with respect to ground and increase, reflecting total cortisol output and HPA axis reactivity, respectively. <br><br>RESULTS: A series of hierarchical regressions revealed no significant main effects of PTSD responder status for either CAR outcome. However, a significant gender by treatment response interaction for cortisol reactivity revealed that female treatment nonresponders displayed higher cortisol reactivity following treatment than female responders, whereas cortisol reactivity did not change pre- to posttreatment for male responders. <br><br>FINDINGS remained after controlling for age, trauma history, baseline medication status, baseline PTSD, and baseline depressive symptoms. <br><br>CONCLUSION: Loss of a PTSD diagnosis may contribute to decreased cortisol reactivity in females. Neuroendocrine changes following treatment may emerge only for specific subgroups, highlighting the importance of exploring treatment moderators.<p /><p>Language: en</p>",
language="en",
issn="1091-4269",
doi="10.1002/da.22298",
url="http://dx.doi.org/10.1002/da.22298"
}